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Emry Negotiates Out-of-Network Surgery Costs Saving Employer $5,400

How Emry Reduced a Large Out-of-Network Surgery Bill for a client

Situation

With no other options in their geography, an employee of an Emry client utilized an out-of-network provider for laparoscopic surgery and was faced with bills large enough to put their family in medical debt.

Service Provided

The Emry conducted a comprehensive Bill Review to identify any errors or discrepancies and utilized our BillAssist platform to streamline the bill negotiation process. Insurance policies pronouncements, clinical policy bulletins, and the surgeon’s supportive documents were utilized to appeal the claim decision on the grounds that the case was medically necessary and no in-network provider in the geography was qualified for the surgery required.

Outcomes

After multiple negotiations with the hospital, Emry successfully secured a settlement of $2,995 as full payment, achieving a 64% savings ($5,403) on the total bill. Since the employer was covering the cost for the employee, this directly saved the client $5,403.

Total Savings:

$5,403

Topics

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